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Birth Positions

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Standing
Advantages

  • Excellent for oxygenation of fetus
  • Uses gravity
  • Contractions are more effective and less painful
  • Helps speed up labor
  • Helps create pushing urge

Disadvantages

  • Poor control of delivery
  • Visualization very hard for birth attendant

Walking
Advantages

  • Uses gravity
  • Contractions often less painful
  • Encourages uterine contractility
  • Baby well-aligned in pelvis
  • May speed up labor
  • Reduces backache
  • Encourages descent

Disadvantages

  • Often mother can't use if she has high blood pressure
  • Can't be used with continuous electronic fetal monitoring

Sitting
Advantages

  • Good for resting
  • Uses gravity
  • Can be used with continuous electronic monitoring
  • Can be used with birth ball to encourage descent

Disadvantages

  • Possibly can't be used if mother has high blood pressure

Sitting on Toilet
Advantages

  • Helps relax perineum
  • Mother accustomed to open-leg position and pelvic pressure in this environment
  • Uses gravity

Disadvantages

  • Pressure from toilet seat can cause pain

Semi-Sitting
Advantages

  • Comfortable for mother
  • Good use of gravity
  • Good resting position
  • Works well in hospital beds
  • Good visibility at delivery for mom, dad and others present
  • Good access to FHTs (Fetal Heart Tones)

Disadvantages

  • Access to perineum can be poor
  • Mobility of coccyx is impaired
  • Some stress on perineum, but less than lithotomy

Lithotomy - (on back, legs raised -- avoid this position!)
Disadvantages

  • Compression of all major vessels
  • Laceration or need for episiotomy is more likely
  • No use of gravity to aid delivery

Side-Lying
Advantages

  • Good fetal oxygenation
  • Good resting position for mother
  • Helpful if mother has elevated blood pressure
  • Useful if mother has epidural anesthesia
  • Often makes contractions more effective
  • May promote progress of labor
  • Easier for mom to relax between contractions during second stage
  • Allows posterior sacral movement in second stage
  • Can slow precipitous delivery
  • Partner may need to support leg
  • Partner can assist in delivery
  • Lowers chance of laceration or need for episiotomy
  • Access to perineum is excellent

Disadvantages

  • Access to FHTs poor if mother is lying on same side as baby's back
  • No help from gravity
  • Mother must support her leg under knee if no one is there to hold leg
  • Mother may feel too passive

Leaning
Advantages

  • Great for rotation of posterior presentation
  • Uses gravity
  • Contractions often less painful
  • Contractions often more productive
  • Baby is well-aligned in pelvis
  • Relieves backache
  • Facilitates use of back pressure
  • May be more restful than standing

Disadvantages

  • Hard for attendant if used at delivery

Kneeling, Leaning Forward with Support
Advantages

  • Helpful with persistent posterior presentation
  • Assists rotation of baby
  • Good for pelvic rocking
  • Good for use with birth ball
  • Less strain on wrists and arms

Squatting
Advantages

  • Encourages rapid descent
  • Uses gravity
  • May increase rotation of baby
  • Allows freedom to shift weight for comfort
  • Excellent for access to the perineum
  • Excellent for fetal circulation
  • May increase pelvis diameter by as much as two centimetres
  • Requires less bearing-down effort
  • Upper trunk presses on fundus to encourage descent
  • Thighs keep baby well-aligned
    Disadvantages
    • Often tiring to mother
    • Sometimes hard to hear FHTs
    • May be hard for mother to assist in delivery

    Hands and Knees

    • Can be disorienting to inexperienced attendant.